Provider Demographics
NPI:1710978812
Name:GREISMAN, STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:
Last Name:GREISMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 W 57TH ST
Mailing Address - Street 2:APT 106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1701
Mailing Address - Country:US
Mailing Address - Phone:212-265-1471
Mailing Address - Fax:
Practice Address - Street 1:457 W 57TH ST
Practice Address - Street 2:APT 106
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1701
Practice Address - Country:US
Practice Address - Phone:212-265-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-30
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157738207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP949OtherOXFORD
NYA63640Medicare UPIN
NY65D491Medicare PIN